Low positive predictive value of International Classification of Diseases, 10th Revision codes in relation to rheumatic heart disease: a challenge for global surveillance

2019 ◽  
Vol 49 (3) ◽  
pp. 400-403 ◽  
Author(s):  
Judith M. Katzenellenbogen ◽  
Lee Nedkoff ◽  
Jeffrey Cannon ◽  
Deborah Kruger ◽  
Filippa Pretty ◽  
...  
Keyword(s):  
Heart Disease ◽  
Positive Predictive Value ◽  
Rheumatic Heart Disease ◽  
Predictive Value ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Classification Of Diseases ◽  
Rheumatic Heart

Use of International Classification of Diseases, Ninth Revision Clinical Modification Codes and Medication Use Data to Identify Nosocomial Clostridium difficile Infection

2009 ◽  
Vol 30 (11) ◽  
pp. 1070-1076 ◽  
Author(s):  
Mia Schmiedeskamp ◽  
Spencer Harpe ◽  
Ronald Polk ◽  
Michael Oinonen ◽  
Amy Pakyz
Keyword(s):  
Drug Therapy ◽  
Clostridium Difficile ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Adult Patients ◽  
Classification Of Diseases ◽  
Sensitivity Specificity

Objective.The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) is used for surveillance of CDI. However, the ICD-9-CM code alone cannot separate nosocomial cases from cases acquired outside the institution. The purpose of this study was to determine whether combining the ICD-9-CM code with medication treatment data for CDI in hospitalized patients could enable us to distinguish between patients with nosocomial CDI and patients who were admitted with CDI. The primary objective was to compare the sensitivity, specificity, and predictive value of using the combination of ICD-9-CM code for CDI and CDI treatment records to identify cases of nosocomial CDI with the sensitivity, specificity, and predictive value of using the ICD-9-CM code alone.Design.Validation sample cross-sectional study.Setting.Academic health center.Methods.Administrative claims data from July 1, 2004, to June 30, 2005, were queried to identify adults discharged with an ICD-9-CM code for CDI and to find documentation of CDI therapy with oral vancomycin or metronidazole. Laboratory and medical records were queried to identify symptomatic CDI toxin-positive adult patients with nosocomial CDI and were compared with records of patients whose cases were predicted to be nosocomial by means of ICD-9-CM code and CDI therapy data.Results.Of 23,920 adult patients discharged from the hospital, 62 had nosocomial CDI according to symptoms and toxin assay. The sensitivity of the ICD-9-CM code alone for identifying nosocomial CDI was 96.8%, the specificity was 99.6%, the positive predictive value was 40.8%, and the negative predictive value was 100%. When CDI drug therapy was included with the ICD-9-CM code, the sensitivity ranged from 58.1% to 85.5%, specificity was virtually unchanged, and the range in positive predictive value was 37.9%–80.0%.Conclusion.Combining the ICD-9-CM code for CDI with drug therapy information increased the positive predictive value for nosocomial CDI but decreased the sensitivity.

Predictive Ability of Positive Clinical Culture Results and International Classification of Diseases, Ninth Revision, to Identify and Classify Noninvasive Staphylococcus aureus Infections: A Validation Study

2010 ◽  
Vol 31 (07) ◽  
pp. 694-700 ◽  
Author(s):  
LaRee A. Tracy ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Mary Singer ◽  
Patricia Langenberg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Predictive Value ◽  
Positive Culture ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Culture ◽  
Classification Of Diseases ◽  
Definition Of

Objective.To develop and validate an algorithm to identify and classify noninvasive infections due toStaphylococcus aureusby using positive clinical culture results and administrative data.Design.Retrospective cohort study.Setting.Veterans Affairs Maryland Health Care System.Methods.Data were collected retrospectively on allS. aureusclinical culture results from samples obtained from nonsterile body sites during October 1998 through September 2008 and associated administrative claims records. An algorithm was developed to identify noninvasive infections on the basis of a uniqueS. aureus-positive culture result from a nonsterile site sample with a matchingInternational Classification of Diseases, Ninth Revision (ICD-9-CM), code for infection at time of sampling. Medical records of a subset of cases were reviewed to find the proportion of true noninvasive infections (cases that met the Centers for Disease Control and Prevention National Healthcare Safety Network [NHSN] definition of infection). Positive predictive value (PPV) and negative predictive value (NPV) were calculated for all infections and according to body site of infection.Results.We identified 4,621 uniqueS. aureus-positive culture results, of which 2,816 (60.9%) results met our algorithm definition of noninvasiveS. aureusinfection and 1,805 (39.1%) results lacked a matchingICD-9-CMcode. Among 96 cases that met our algorithm criteria for noninvasiveS. aureusinfection, 76 also met the NHSN criteria (PPV, 79.2% [95% confidence interval, 70.0%–86.1%]). Among 98 cases that failed to meet the algorithm criteria, 80 did not meet the NHSN criteria (NPV, 81.6% [95% confidence interval, 72.8%–88.0%]). The PPV of all culture results was 55.4%. The algorithm was most predictive for skin and soft-tissue infections and bone and joint infections.Conclusion.When culture-based surveillance methods are used, the addition of administrativeICD-9-CMcodes for infection can increase the PPV of true noninvasiveS. aureusinfection over the use of positive culture results alone.

scholarly journals Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)

2021 ◽  
pp. 215013512110329
Author(s):  
Jeffrey P. Jacobs ◽  
Rodney C. G. Franklin ◽  
Marie J. Béland ◽  
Diane E. Spicer ◽  
Steven D. Colan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Cardiac Care ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Cardiac Component

Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code ( IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC. The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.

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